Filtering by Tag: lower back

Most folks have a vague idea of what's going on in their backs, but let's clarify. In your vertebral column, you have 24 vertebrae: 7 cervical (neck), 12 thoracic (thorax-ribs area), and 5 lumbar. The cervical vertebrae are the most mobile, giving you the ability to turn your neck in many positions. The thoracic ribs articulate with your 12 sets of ribs to protect the viscera, assist in breathing, etc. The lumbar vertebrae are larger, less mobile, and support the weight of the torso.

When viewed from the side, the spine has a series of natural lordatic and kyphotic curves. Poor alignment often distorts these curves into a single C curve.

In between each vertebra is a cartilaginous "invertebral disc," which I mentioned last week in relation to osteoporosis. These discs act as shock absorbers while also helping to maintain the structure of the spine. Misaligned discs can be painful, or not. Many people have slightly herniated discs (meaning displaced) and have no pain or symptoms from it while others have serious issues, including compressed nerves and persistent pain.

Muscularly speaking, there are many layers of muscle stacked on top of each to make up this portion of your posterior kinetic chain (a fancy way of side your backside). Our deepest level of posterior muscles are a series of very small muscles running between individual vertebrae, specifically the transversospinalis muscles. They assist with maintaining healthy curvature of the back, as well as bring the spine into extension, or what we think of as a backbend. The intermediate musculature is what you see here on the right-this series of long cord-like structures, which assist in extension as well as side bending in the spine.

Superficial musculature is often more of what you can see on someone's back side-muscles like the trapezius, latissimus dorsi, etc., both of which play a major role in moving the shoulders and neck, as well as spine. (Lats are a big player in pull ups, and the trapezius often gets very tight and restricted in musicians).

A detailed look at the muscles of the back and shoulders, courtesy of Encyclopedia Brittanica. The left view is the topical view, sans epidermis, and the view on the right peels one layer of back myofascia off to look deeper.

I found this image on the internet, but I have no idea where it came from. I do love it, though!

Your spine moves ultimately in 6 directions- round, extend (hello cat/cow), side bend both sides, and twist both sides. The musculature of your back (as well as the muscles of your front) help support the spine and organs as you make these movements, which help keep the invertebral discs healthy, and lengthen compressed areas in the body. The muscles of your pelvis and abdomen are also incredibly important to postural maintenance and stability, but we'll talk about those another day.

Can you see how if a musician is short in one side of their body, due to an asymmetrical instrument, they might have misalignment and back pain?

Sometimes at social gatherings, people will ask me to fix their posture, AKA. "Tell Us what we're doing wrong, right now!" This is what I tried to tell them, albeit only somewhat successfully.

As musicians, movers, and teachers, most of us have been taught "good posture" markers, like sit/strand up straight, shoulders back, head upright, suck in the belly. Ironically, many of these cues will not yield good posture at all, but will hide the body's deficiencies through overcorrection. For most of us, this was continue out into our daily activities, including yoga, weight lifting, running, etc. and yields rib thrust or rib flare. What is this, you ask? Take a look at this image below of Katy Bowman, biomechanics movement goddess.

Take a look at the three difference variations of posture (there are infinite variations- these are just a few). Which one looks "the best" to you? Number three?- in which the body is upright and the shoulders back? Or Number Two, in which the spine looks slightly rounded or kyphotic? Also look at the vertical plumb line between the three images- only number two has the head stacked over the heels. In both image one and three, the head is trailing forward of the heels. Which image do you most resemble? The "best aligned" posture of these three is not number three, but number two, in which the body's natural spinal curves are preserved, and the head, ribs, and pelvis are all in a unified line. Number three reveals the rib thrust, which can be defined as the ribs moving forward of the pelvis which then does gnarly things to the lumbar (low back) spinal vertebrae. This is separating an aesthetic marker (shoulders back, chest forward) from a true body alignment marker (ribs and head over hips and heels).

Time out: What are forces? Has it been awhile since you studied physics? (For me, over a decade, so force = mass x acceleration) Fear not- gravity (a force) is still working with you. There are other forces (non Star Wars related) working on you as well in movement, including tension, compression, shear, and torsion. Go read about them here!

So even if this whole force thing isn't making sense, you can see that the ribs are shifting forward of the pelvis, right? What that does is compress the lower vertebrae, as well as make for some unhappy soft tissues, a dysfunctional core (can lead to diastasis recti, especially when pregnancy and post natal issues are coming up ), and a possibly dysfunctional pelvic floor (incontinence, pain, etc.) amongst other things. (See this woman on the right? Does she have "good posture" or is she just masking her body's dysfunction by pushing her ribs forward and throwing her shoulders back?

Most of us have some degree of rib thrust, but it will manifest more often when wearing high heels, because the body is trying to mask the inherent distortion that high heels creates for the spine. (Gentlemen, most likely your dress shoes have a heel, so you are not immune to this conversation)

Bad posture to bad posture- not bad to good! Image on left shows the over-rounding, or kyphosis of the upper back with the pelvis forward of the heels, image on right shows rib thrust, to appear to have "good posture."

Let's review- in the rib thrust, the bottom most ribs are shifting forward of the pelvis, which draws the scapula back and creates the illusion of good posture (upright body, broad collarbones). It is in fact masking the issues at hand, which are lack of mobility in the thoracic spine, and possibly hyper-kyphosis, as seen in the image on the right. So what can we do about the over-slump? Start to work on thoracic mobility, shoulder mobility (with stable ribs), and keeping the bottom-most ribs down.

So first, do some exploration, and see where you fall in the spectrum- where are your ribs hanging out?

Our spine begins as a primary C curve in the womb (think sleeping on your side in a ball), but as we mature, we develop secondary curves in response to gravity That first C curve is called kyphotic, with the curves in the neck and low back called lordotic. If we were to make this a little clearer, a curve that moves in towards the body is called a lordotic curve, and a curve that moves away from the body is kyphotic. The result of these two kinds of curves is a wave like, "S like" curve in the spine.

Now why all the fuss about these two words? Well, many of us have excessive tendencies, either excessive kyphosis or excessive lordosis. When we talk about the slumpy, rounded, poor posture tendencies, we're talking about excessive kyphosis. The thoracic (mid back/spinal vertebrae in line with the ribs) region is where our normal kyphotic curve is, and excessive kyphosis is an exaggeration of that position. Many of us musicians have this position when handling our instrument, either because of the music stand in front of us (or sharing with another), because our head juts forward, or our cell phones/cars/sitting habits put us in this position.

Excessive lordosis, on the other hand, is less common, but still a possibility. If you look at the spine, the lordotic curve is in the lumbar region, meaning that excessive lordosis is an exaggerated lumbar curve. Now if that concept is obscure to you, think of gymnasts, dancers, ice skaters, etc., for whom this posture is normal, especially on completion of a competition or performance. Musicians are not as likely to have this position, but I have seen it from time to time.

Last but not least is the combo package- lordosis-kyphotic posture. I have seen this a lot, and it deserves a full post unto itself, but as you can see, it combines both excessive lordosis and kyphosis together into one uncomfortable body position. People with this position tend to have their upper body behind their pelvis, but still have the slump rounded forward position. While posture is not everything, it is a good thing to start to recognize in yourself and in your students. Misalignment over a long period of time can lead to joint wear and tear, pain (sometimes), or just not playing, breathing, or feeling as well.